Description:

NCT00103181 NSABP Protocol B-39 Radiation Therapy Report for Patients Randomized to PBI (Group 2 Patients Only) Radiation Therapy in Treating Women Who Have Undergone Surgery For Ductal Carcinoma In Situ or Stage I or Stage II Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E74A3E53-F9E9-58E3-E034-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E74A3E53-F9E9-58E3-E034-0003BA3F9857

Keywords:
Versions (3) ▾
  1. 8/26/12
  2. 1/9/15
  3. 7/5/15
Uploaded on:

July 5, 2015

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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NCT00103181 NSABP Protocol B-39 Radiation Therapy Report for Patients Randomized to PBI (Group 2 Patients Only)

This form is required for all patients who were randomized to PBI (Group 2) -- even those who did not start PBI.

  1. StudyEvent: NSABP Protocol B-39 Radiation Therapy Report for Patients Randomized to PBI (Group 2 Patients Only)
    1. This form is required for all patients who were randomized to PBI (Group 2) -- even those who did not start PBI.
Header
Are data amended (check box if yes, and circle amended items)
Radiation Therapy Report
Type of Radiation Therapy Received (prior to treatment failure or second primary cancer)
PBI Technique (mark one)
Side Irradiated
Were there any unscheduled interruptions in radiation therapy due to toxicity?
Were there any unscheduled interruptions in radiation therapy for other reasons?
Reason PBI Treatment Ended

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